Remote Ischemic Preconditioning May Attenuate Renal Ischemia-Reperfusion Injury in a Porcine Model of Supraceliac Aortic Cross-Clamping

Athanasiadis, Dimitrios; Kapelouzou, Alkistis; Martikos, Georgios; Katsimpoulas, Michalis; Schizas, Dimitrios; Vasdekis, Spyros N.; Kostakis, Alkiviadis; Liakakos, Theodore; Lazaris, Andreas

doi:10.1159/000439219

Cited by 9 publications

(8 citation statements)

References 58 publications

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“…Other scholars, such as Chao CS, found that when the occlusion time of the zone II abdominal aorta in pigs exceeded 30 minutes with a balloon catheter, the intra-abdominal pressure increased, pathological changes in multiple organs occurred, and the mixed venous oxygen saturation was reduced (15). Athanasiadis D et al concluded that Scr levels increased 30 min after abdominal aorta occlusion above the celiac trunk in pigs with open aneurysms (16).…”

Section: Discussionmentioning

confidence: 99%

The Effects of Increasing Aortic Occlusion Times at the Level of the Highest Renal Artery (Zone II) in the Normovolemic Rabbit Model

et al. 2022

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The purpose of this study was to evaluate the effects of increasing zone II resuscitative endovascular balloon occlusion of the aorta (REBOA) occlusion times on physiological, end-organ and inflammatory responses in rabbits to assess the safe aortic occlusion time in a normovolemic rabbit model. Methods:The zone ll aorta was occluded with a balloon in 32 rabbits (8 animals each for 15, 30, 60, and 90 min). 8 rabbits served as a control. ELISAs were used to examine the serum levels of ALT, AST, Cr, BUN, MDA, SOD, IL-8, IL-6, and TNF-a; HE staining was used to identify the morphological changes in the kidney; RT-PCR was used to detect the mRNA levels of IL-6, IL-8, TNF-a and NF-kB in the kidney and uterus; and Western blotting was used to measure the protein expression levels of IL-6, IL-8, TNF-a and NF-kB in the kidney and uterus.Results: Plasma concentrations of liver markers, kidney markers, inflammatory factors and oxidative stress indicators were significantly increased at the end of reperfusion in the 30 min, 60 min and 90 min groups. Damage to the kidney occurred in the 30 min, 60 min and 90 min groups. The mRNA and protein expression levels of IL-6, IL-8, TNF-a and NF-kB in the kidney and uterus were significantly increased at the end of reperfusion in the 30 min group, and as the time of occlusion extended, these levels continued to increase. Conclusion:Activation of systemic inflammation and ischaemia-reperfusion injury of end-organs occurred when the occlusion time reached 30 min. Therefore, 15 min should be regarded as a safe period of REBOA in zone II.

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Section: Discussionmentioning

confidence: 99%

The Effects of Increasing Aortic Occlusion Times at the Level of the Highest Renal Artery (Zone II) in the Normovolemic Rabbit Model

et al. 2022

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“…Other scholars, such as Chao CS, found that when the occlusion time of the zone II abdominal aorta in pigs exceeded 30 minutes with a balloon catheter, the intra-abdominal pressure increased, pathological changes in multiple organs occurred, and the mixed venous oxygen saturation was reduced [11] . Athanasiadis D et al concluded that Scr levels increased 30 min after abdominal aorta occlusion above the celiac trunk in pigs with open aneurysms [12] .…”

Section: Discussionmentioning

confidence: 99%

Resuscitative Endovascular Balloon Occlusion of the Aorta in a Normovolemic Rabbit Model: a Pilot Study

Liu¹,

Zhang²,

Xie³

et al. 2021

Preprint

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Background: The purpose of this study was to verify physiological, end-organ and systemic inflammatory changes in zone II after resuscitative endovascular balloon occlusion of the aorta (REBOA) in a normovolemic rabbit model.Methods: Anaesthetized rabbits were subjected to aortic balloon occlusion for different times (15 min, 30 min, 60 min and 90 min) followed by 2 h of reperfusion. Rabbits with no balloon occlusion were set as the control group. ELISAs were used to examine the serum levels of ALT, AST, Cr, BUN, MDA, SOD, IL-8, IL-6, and TNF-α; HE staining was used to identify the morphological changes in the kidney; RT-PCR was used to detect the mRNA levels of IL-6, IL-8, TNF-α and NF-κB in the kidney and uterus; and Western blotting was used to measure the protein expression levels of IL-6, IL-8, TNF-α and NF-κB in the kidney and uterus.Results: Plasma concentrations of liver markers, kidney markers, inflammatory factors and oxidative stress indicators were significantly increased at the end of reperfusion in the 30 min, 60 min and 90 min groups. Damage to the kidney occurred in the 30 min, 60 min and 90 min groups. The mRNA and protein expression levels of IL-6, IL-8, TNF-α and NF-κB in the kidney and uterus were significantly increased at the end of reperfusion in the 30 min group, and as the time of occlusion extended, these levels continued to increase.Conclusion: Activation of systemic inflammation and ischaemia-reperfusion injury of end-organs occurred when the occlusion time reached 30 min. Therefore, 15 min should be regarded as a safe period of REBOA in zone II.

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“…In regard to sevoflurane, we have not identified any renal rIC studies using this agent. In contrast, the related agent isoflurane is widely used both in small and large animal studies, where renoprotective effects of rIC is reported in some [ 23 , 29 – 32 ] but not all [ 16 , 20 ]. Sevoflurane in combination with buprenorphine was chosen since they provide optimal anaesthetic and analgesic effects in combination with a safe profile when compared with i.v.…”

Section: Discussionmentioning

confidence: 99%

No Effect of Remote Ischemic Conditioning Strategies on Recovery from Renal Ischemia-Reperfusion Injury and Protective Molecular Mediators

et al. 2015

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Ischemia-reperfusion injury (IRI) is the major cause of acute kidney injury. Remote ischemic conditioning (rIC) performed as brief intermittent sub-lethal ischemia and reperfusion episodes in a distant organ may protect the kidney against IRI. Here we investigated the renal effects of rIC applied either prior to (remote ischemic preconditioning; rIPC) or during (remote ischemic perconditioning; rIPerC) sustained ischemic kidney injury in rats. The effects were evaluated as differences in creatinine clearance (CrCl) rate, tissue tubular damage marker expression, and potential kidney recovery mediators. One week after undergoing right-sided nephrectomy, rats were randomly divided into four groups: sham (n = 7), ischemia and reperfusion (IR; n = 10), IR+rIPC (n = 10), and IR+rIPerC (n = 10). The rIC was performed as four repeated episodes of 5-minute clamping of the infrarenal aorta followed by 5-minute release either before or during 37 minutes of left renal artery clamping representing the IRI. Urine and blood were sampled prior to ischemia as well as 3 and 7 days after reperfusion. The kidney was harvested for mRNA and protein isolation. Seven days after IRI, the CrCl change from baseline values was similar in the IR (δ: 0.74 mL/min/kg [-0.45 to 1.94]), IR+rIPC (δ: 0.21 mL/min/kg [-0.75 to 1.17], p > 0.9999), and IR+rIPerC (δ: 0.41 mL/min/kg [-0.43 to 1.25], p > 0.9999) groups. Kidney function recovery was associated with a significant up-regulation of phosphorylated protein kinase B (pAkt), extracellular regulated kinase 1/2 (pERK1/2), and heat shock proteins (HSPs) pHSP27, HSP32, and HSP70, but rIC was not associated with any significant differences in tubular damage, inflammatory, or fibrosis marker expression. In our study, rIC did not protect the kidney against IRI. However, on days 3–7 after IRI, all groups recovered renal function. This was associated with pAkt and pERK1/2 up-regulation and increased HSP expression at day 7.

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Remote Ischemic Preconditioning May Attenuate Renal Ischemia-Reperfusion Injury in a Porcine Model of Supraceliac Aortic Cross-Clamping

Cited by 9 publications

References 58 publications

The Effects of Increasing Aortic Occlusion Times at the Level of the Highest Renal Artery (Zone II) in the Normovolemic Rabbit Model

The Effects of Increasing Aortic Occlusion Times at the Level of the Highest Renal Artery (Zone II) in the Normovolemic Rabbit Model

Resuscitative Endovascular Balloon Occlusion of the Aorta in a Normovolemic Rabbit Model: a Pilot Study

No Effect of Remote Ischemic Conditioning Strategies on Recovery from Renal Ischemia-Reperfusion Injury and Protective Molecular Mediators

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